Recommendation 157

This recommendation is assigned to CSNSW and Justice Health NSW.

Recommendation

That, as part of the assessment procedure outlined in Recommendation 156, efforts must be made by the Prison Medical Service to obtain a comprehensive medical history for the prisoner including medical records from a previous occasion of imprisonment, and where necessary, prior treatment records from hospitals and health services. In order to facilitate this process, procedures should be established to ensure that a prisoner's medical history files accompany the prisoner on transfer to other institutions and upon re-admission and that negotiations are undertaken between prison medical, hospital and health services to establish guidelines for the transfer of such information.

Context

The Royal Commission Report identified that adequate assessment of a prisoner is dependent upon the information available at the time of assessment and that access to records from outside agencies by corrections would be of significant benefit. The balance between privacy and public interest was acknowledge noting that most jurisdictions had a consent process in place for the release of medical information of a person in custody. Information in prison medical service files are also of importance and the Royal Commission noted a delay in some of the transfer of those medical files between prisons in their cases investigated. Recommendation 157 is directed at ensuring accurate and up to date medical histories are available for persons in custody and that medical files are transferred in a timely manner.

Detail of implementation

CSNSW continues to transport inmates with their medical records, and this is reflected throughout Custodial Operations Policy and Procedures 19.10 section 10 records for escorts. 

Justice Health NSW response

Justice Health NSW acknowledge the importance of this recommendation, and note it is no longer contemporary through the 2015 introduction of JHeHS electronic health record which captures previous health records from custody. Justice Health NSW Clinical Handover Policy 1.075 details the transfer of patient health information utilising the ISBAR format in a range of scenarios including clinical handover of the deteriorating patient, patients of concerns and emergency scenarios; clinical handover of patients at reception to custody; clinical handover of patient transfers between custodial centres; patient transfer to and from external providers; shift to shift and clinic session handover; and patient discharge from custody. 

In November 2022 NSW Health announced progress towards the digital transformation of healthcare with a unified Single Digital Patient Record for the state's public health system. The Single Digital Patient Record will replace over 20 existing electronic medical, administrative, pathology and other clinical support systems currently in use. This will enable electronic access to real time health records providing comprehensive information to treating teams when they need it for a seamless care experience for patients.

Medical histories including health conditions, medications, current treatment and risks are obtained from the patient on entry to custody through the Reception Screening Assessment. Justice Health NSW may request information about current patients from external care providers, including hospitals, outpatient/community facilities, General or Specialist practice and medical centres. With patient consent, Justice Health NSW seeks further health information from external provider by submitting a request to them using the NSW Health state approved JUS020.083 Consent to Obtain Health Information for Continuation of Care form.

Medical histories and other health information is securely stored in the patient’s electronic health record. Established in 2015, the Justice Health electronic Health System (JHeHS) includes health information from previous entries to custody. A new Electronic Medication Management (eMeds) system was rolled out in 2023. Integrated into JHeHS, the system allows authorised clinicians to prescribe medications, record administration of medications, and review a patient’s medication order online. 

Justice Health also has procedures in place for the clinical handover of inmates between shifts and when being transferred, in emergencies, reception to custody etc. This includes the MoU between NSW Health and CSNSW, Justice Health policies 1.075 Clinical Handover and 1.395 Transfer and Transport of Patients, and Justice Health Form CNS590 Information for NSW Health Hospital Staff Delivering Care to a Custodial Patient. The use and disclosure of custodial patient health information is further outlined in Justice Health NSW Policy 4.030 Requesting and Disclosing Health Information and Guideline 9.036 Use and disclosure of health information.

Justice Health NSW Policy 1.075 Clinical Handover details the transfer of patient health information using the ISBAR format in a range of scenarios including clinical handover of the deteriorating patient, patients of concerns and emergency scenarios; clinical handover of patients at reception to custody; clinical handover of patient transfers between custodial centres; patient transfer to and from external providers; shift to shift and clinic session handover; and patient discharge from custody. 

In November 2022 NSW Health announced progress towards the digital transformation of healthcare with a unified Single Digital Patient Record for the state's public health system. The Single Digital Patient Record will replace over 20 existing electronic medical, administrative, pathology and other clinical support systems currently in use. This will enable electronic access to real time health records providing comprehensive information to treating teams when they need it for a seamless care experience for patients.

Inmates’ property and medical paperwork will be moved on the same transport vehicle as the inmate. There are occasions when property will not move on the same truck as the inmate; these maybe reasons such as property left behind accidently, no room on the truck etc. However, this is on the very odd occasion.

Evidence 

• Justice Health Policies

• Custodial Operations Policy and Procedures 19.10 section 10 records for escorts (not publicly available)